AN IMPORTANT ROLE IN PATIENT CARE
Endocrine clinical nurse specialists (CNSs) are autonomous practitioners with specialist nursing knowledge who can work in many areas of endocrinology.
We can have an impact on waiting times for patients by running nurse-led clinics. Here, we are well placed to provide evidence-based practice, education and advice, including verbal, written and practical demonstration (e.g. intramuscular hydrocortisone injection). Repetition of this education is important, so providing a consistent contact for patients is beneficial. Educating patients empowers them to manage chronic conditions, make informed choices and support self-care, as does signposting resources and support groups.
We are able to assess, plan and manage programmes of care, including the performance of dynamic testing. Through monitoring and evaluating a patient’s progress, care plans can be continuously modified. CNSs can be involved in triage and respond to clinical questions through referral processes, interacting with different care providers. We also support the multi-disciplinary team within hospital trusts with education. By consulting with and advocating for patients, we can help shape services via trust management links.
CURRENT TRAINING NEEDS AND ROLES
By regularly evaluating and reflecting on the services we provide, we can highlight areas for improvement and seek knowledge and training opportunities to achieve the highest standards in practice. It is the responsibility of the individual to recognise and escalate any gaps in knowledge, and to seek the assistance of others or the Society for Endocrinology to assist with learning or provide support.
As CNSs and experts in our field, we should strive to be competent and confident in the service we provide for our patients. Guided by the Competency Framework for Adult Endocrine Nursing (second edition; www.endocrinology.org/careers/training-and-resources), we shall aim to achieve a high level of knowledge and competency within our area of specialty through reflection, patient care and evidence-based practice.
We shall continue to overcome the obstacles to training presented by COVID-19, making use of online avenues such as webinars, group discussion, data collection and online networking. Early last year, data collection identified the additional training requirements of early career endocrine nurses. These included online training, an online resource page, a mentorship system and the chance to build connections and network. The Society for Endocrinology has since offered numerous training opportunities, including nurse-led webinars, ‘Lunchtime Chats’, online surveys and conferences.
FUTURE TRAINING NEEDS
Through data collection and analysis, we can evaluate the current and future status of the endocrine CNS community, highlighting the levels of experience and areas for development, and the training needs of individuals and trusts. This information can then be used as a focal point to guide relevant training, suitable to appeal in the current climate. As the knowledge and understanding of endocrinology are expanding with services developing across the country, future training will be required to ensure the CNSs needs are met. Hence networking and providing peer support and connections are essential to streamline the endocrine service on a national scale.
As the knowledge and understanding of endocrinology are expanding with services developing across the country, future training will be required to ensure the CNSs needs are met.
Feedback from early career nurses has introduced the concept of a mentorship system. This aims to pair senior and junior nurses from across the country, to assist and support each other in their personal and professional growth, and to streamline services to mould the future of nursing in endocrinology. As well as demonstrating the numerous possibilities within endocrinology, it will emphasise the field’s vast range of nursing career opportunities.
As the demand for nurse-led clinics increases, there will be an additional need for training in sub-specialties. We would like to continue the training and support surrounding nurse-led clinics, such as subject knowledge, accountability and legal matters, prescribing and the running of nurse-led clinics to achieve optimal care for our patients.
HOPES AND THOUGHTS ON THE FUTURE
We should promote the diversity of the endocrine CNS role, and encourage nurses from all backgrounds who have transferable skills to consider a career in endocrinology.
We should also continue to support and encourage nurses to complete academic qualifications, such as the non-medical prescribing course and the MSc Module in Endocrine Nursing, as these are beneficial both to patients and to career progression. It is inspiring to see career development and opportunities such as advanced nursing practice, clinical leads and nurse consultant posts. Roles in academia and research are also continuously developing.
We would like to see more CNSs presenting at national conferences (e.g. presenting a patient case or showing the achievements of a quality improvement project). A lot of interesting work is carried out in hospitals across the country, and this sharing of ideas could benefit many patients nationally or even internationally.
Many larger teaching hospitals have developed their services through condition-specific sub-specialty nurses. It will be interesting to see if these roles develop within district general hospitals if those departments expand.
As a national group of CNSs, we support each other with policies, protocols, guidelines and patient information leaflets. It could benefit nurses who are new to this role if hospitals in neighbouring areas or regions worked together to support practical skills education (e.g. through dynamic function testing or exposure to specialist nurse-led clinics). Regional maps of CNS contacts for peer support could be considered.
The future role of the endocrine CNS is exciting and full of possibilities and opportunities. It’s a fantastic time to have this role and develop within your areas of practice.
Endocrine Clinical Nurse Specialist, Stockport NHS Foundation Trust Society for Endocrinology Early Career Steering Group
Endocrine Specialist Nurse, Maidstone and Tunbridge Wells Trust
Early Career Representative, Society for Endocrinology Nurse Committee and Early Career Steering Group